Being In the Moment: What I learned – My first delivery as an L&D Nurse

In the eight years I've been a labor nurse, I've been fortunate to participate in hundreds of deliveries and learn so much along the way. It was my experience with my labor nurse as a new mom that drew me to this kind of nursing. I've learned that caring for a labor patient goes far beyond simply managing care, contraction pain relief, charting, and deliveries... there's a certain intuitive mindset that comes into play that you develop over the years as a labor nurse.

For my very first delivery as a new orientee, my preceptor took me to a room where a patient was actively pushing. She brought me in and stood me next to the bed to hold one of the patient's legs back as she pushed. She wasn't my patient, we were called in to "help" with the delivery.

As I stood there awkwardly holding her leg, I tried to introduce myself, she looked quickly in my direction with a, "I don't give a crap who you are I'm trying to have a baby" kind of look. The feeling was intrusive and surreal, I just met this woman and suddenly I was plunked next to her during one of the most vulnerable times of her life.

That's one thing you can say nurses are great at, we get personal real quick in deliveries. We go from introduction to holding a leg in 0.2 seconds.

I had three children of my own so I had a good idea as to how the delivery was going to go. However, it is a whole different story when you're not the labor patient yourself. Even in nursing school I wasn't able to see a vaginal delivery because there just wasn't an opportunity.

From experience, sometimes deliveries can take hours or just a few minutes, at the time I had no idea how to tell... I don't think I even checked a cervix yet. I was as green as green could be, all I had was my personal labor experience.

The patient pushed and the nurses coached her along. Without saying a word, the nurses seemed to know everything before it would happen. They soon started to "set her up" (meaning, break the bed, put her in stirrups, and get the doctors gowned, gloved, and ready to catch.) The head was coming down and I could see it, but it amazed me how the nurses and doctors knew -almost, to the contraction- when the baby would be born based on how the patient was pushing.

The last pushes and finally the baby was born!

When the baby made his first cry I found that I was emotional and somewhat stuck in the moment. How awesome it was to get the opportunity to participate in such an influential moment in a stranger's life! I remember the Mom and Dad's screams of joy and relief when he finally arrived, the new Grandmother was in the corner crying her eyes out because this was her first grand baby, and all the emotions they were feeling were palpable to me.

I'll never forget the scene of that room, how proud it made me feel to be a part of it, and the rush of emotion that brought me to tears when the baby was delivered.

"I wouldn't be able to remember all the deliveries I have participated in, but this one stood out because it made me realize how much went into even a normal, healthy vaginal delivery."

When the baby was out, I had no idea what to do and felt as if I was watching a movie play out as part of the audience instead of being a part of the cast. Everyone in the room had a task that they were working diligently to complete. Sure, it was my first delivery but the feeling of not knowing what to do was paralyzing and awkward.

My preceptor took the lead and talked me through what she was doing, what I should have been doing, and assumed responsibility of assessing the newborn. She dried and stimulated the baby, suctioned his mouth and nose, and once she felt he was safely transitioning she snuggled him under blankets with the new mother skin to skin.

The second delivery nurse was helping the doctors, documenting, and hanging Pitocin. She effortlessly buzzed around the room accomplishing tasks that I hadn't even known existed yet. The doctors and residents were quietly talking shop while the patient was still in stirrups. They congratulated the new mom, helped dad cut the umbilical cord, and prepared to repair the vaginal laceration.

"The work ethic in the room was calm, cheerful, and business as usual."

So much was happening that was important... and medical... and pertinent to mom and baby's well-being, but all I could do was stand there caught up in the moment.

After a solid year of working L&D, I finally began to feel comfortable in most deliveries. Little by little, I got more efficient in providing care and being in the moment. During that first year, when it seemed it was starting to click, something would throw me for a loop and put me in my place. Labor and delivery has a way of bringing you back a few notches when you think you have it all figured out. A shoulder dystocia, increased bleeding, or any other complication can happen at any time, you always have to be ready.

Eight years later, when I see new L&D nurses standing around awkwardly completely lost, like I was at my first delivery, my heart goes out for them and I understand their struggle. I know with time and patience, if they truly love labor and delivery nursing, they'll become great labor nurses, too.

There is so much to learn and so much to prepare for that you have to be patient with yourself, ask questions, and know that you will feel dumb every now and again.

In all my deliveries, no two have been exactly the same. There are so many variables that can change a normal course of labor, maternal or fetal complications, an unusual family dynamic, or even the medical provider's preferences can play a part in the overall outcome.

I have learned to be fluid, always expect the unexpected, and trust my instincts. I love a good delivery as much as any labor nurse, but a good labor nurse never lets her guard down to think a normal labor will always result in a normal birth.

Deliveries can be unpredictable and you must learn to be in the moment.

Being a part of your patient's birth is only a tiny piece of the puzzle and a "perk of the job." Laboring with a mom, watching a mother get relief from her epidural, or handing the new baby off to Dad for the first time are some of the special moments that I get to share with my patients.

A great labor nurse, to me, is able to motivate and encourage a mom to push through her pain, fear, and exhaustion, all while being one step ahead of the game to ensure she has a safe delivery.

Maternal and fetal complications can make a normal labor scary for both mom and baby. It's being in the moment to turn those close calls into good outcomes which give me pride in what I do, and how far I've come since that very first delivery, all the rest is just the icing on the birthday cake.

Have you come a long way since your very first day on your nursing unit? What was one of the obstacles you had to overcome?

Truly enjoyed reading this! I remember how helpful the nurse was with my first Labor and Delivery. It is people like her and YOU that make the the process a whole lot easier. Thanks for all y’all do ❤️